Methods of use of follicular unit harvesting tools for severing connective tissue

ABSTRACT

Devices and methods are disclosed which provide for harvesting hair follicular units, including severing any remaining connective tissue strands during the harvesting process, so that the harvested follicular units are retained in the harvesting tool without being damaged. The devices and methods of the present invention are especially useful with the partially or substantially automated systems and methods for hair harvesting and transplantation. The follicular unit harvesting tools may comprise a harvesting cannula and a grasping device moveable relative to each other.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a division of co-pending U.S. patentapplication Ser. No. 12/134,165 filed Jun. 5, 2008 and entitled“Follicular Unit Harvesting Tools including Devices and their Use forSevering Connective Tissue”, which claims the benefit under 35 U.S.C.§119 to U.S. Provisional Application No. 60/946,236, filed on Jun. 26,2007, the contents of which are incorporated herein by reference asthough set forth in full.

FIELD OF INVENTION

This invention relates generally to devices and methods used for theharvesting and/or transplantation of hair follicles and follicularunits, and more particularly to devices and methods for effectivelysevering follicular units from connective tissue during the harvestingprocess.

BACKGROUND

Hair transplantation procedures are well-known, and typically involveharvesting donor hair grafts, for example, from the side and back fringeareas of the patient's scalp (“donor areas”), and implanting theharvested grafts in a bald area (“recipient area”). Historically, theharvested hair grafts were relatively large (3-5 mm), although morerecently the donor grafts may be single “follicular units,” which arenaturally occurring aggregates of 1-3 (and much less commonly, 4-5)closely spaced hair follicles that are distributed randomly over thesurface of the scalp. In one well-known process, a linear portion of thescalp is removed from a donor area by dissection, using a scalpel to cutdown into the fatty subcutaneous tissue. The strip is dissected (under amicroscope) into the component follicular units, which are thenimplanted into a recipient area in respective puncture holes made by aneedle. Forceps are typically used to grasp and place the follicularunit grafts into the needle puncture locations, although otherinstruments and methods may also be used.

In “Androgenetic Alopecia” (Springer 1996), M. Inaba & Y. Inaba discloseand describe a method for harvesting singular follicular units bypositioning a hollow punch needle having a cutting edge and interiorlumen with a diameter of 1 mm, which is about equal to the diameter ofcritical anatomical parts of a typical follicular unit. The needle punchis axially aligned with an axis of a follicular unit to be extracted andthen advanced into the scalp to cut the scalp about the circumference ofthe selected follicular unit. Thereafter, the follicular units areeasily removed, e.g., using forceps, for subsequent implantation into arecipient site with a specially devised insertion needle.

U.S. Pat. No. 6,585,746 (Gildenberg) discloses using a robotic systemfor hair transplantation, the system including a robotic arm and a hairfollicle introducer associated with the robotic arm. U.S. PatentPublications 2007/0078466 and 2007/0078475, which are each assigned toRestoration Robotics, Inc., of Mountain View, Calif. (assignee of thepresent application), also disclose automated (e.g., robotic) systemsused for transplanting hair follicular units, including a multi-parttool assembly carried on a robotic arm. The tool assembly isindependently controllable relative to the robotic arm, and includes aninner, “harvesting” cannula with a longitudinal axis that isautomatically aligned (under image-guidance) with a selected follicularunit to be harvested from a donor area of a body surface, and thenadvanced relative to the body surface so that an open, tissue coringdistal end of the harvesting cannula penetrates the body surfacesurrounding the selected follicular unit to a depth sufficient tosubstantially encapsulate the follicular unit. The harvesting cannula isthen withdrawn from the body surface with the follicular unit engaged byand retained in an interior lumen thereof. An outer, “implanting”cannula is disposed coaxially over (and moveable relative to) theharvesting cannula, wherein a tissue piercing distal end of theimplanting cannula is used to puncture a recipient area of the bodysurface and form an implantation cavity, with the follicular unitdisplaced from the harvesting cannula lumen into the implantationcavity.

Some manual and partially automated devices for hair harvesting andtransplantation that are known in the art include, for example, the useof a vacuum source to assist in extracting hair follicles from a bodysurface. However, it has been determined that during the harvestingprocedure, the vacuum source may not always provide enough “grasping”force to fully extract the follicular unit from the body surface. Forexample, tissue strands may sometimes tether the follicular unit to thescalp as the follicular unit is being retracted from the scalp, and canend up pulling the follicular unit out of the harvesting cannula, evenagainst the force of the vacuum source. In addition, the pulling forceof the tissue strands may damage the follicular unit, even if it breaksfree from the scalp.

SUMMARY OF THE INVENTION

Devices and methods are disclosed and described which provide forharvesting hair follicular units, including cleanly severing anyremaining connective tissue strands during the harvesting process, sothat the harvested follicular units are retained in the harvestingcannula without any substantial damage. More particularly, variousembodiments of follicular unit harvesting apparatus utilizing one ormore grasping devices for grasping the harvested follicular units uponretraction from the body surface are disclosed and describe herein. Invarious embodiments, the grasping device extends just distally beyondthe distal end of the harvesting cannula, and grasps (and in someembodiments severs or causes to be severed, or both grasps and severs)any remaining connective tissue attached to the harvested follicularunit as the harvesting cannula exits the skin surface with the harvestedfollicular unit contained therein. In various embodiments, the graspingdevice may comprise a pair of opposing arms, each arm having a tip whichmoves into contact with (or very close proximity to) the other tip whenthe grasping device is in the closed position. Some embodiments simplyclamp the strands of tissue and sever the tissue by pulling force, whileother embodiments having cutting tips which cut the strands.

In one embodiment, a follicular unit harvesting tool includes aharvesting cannula having an interior lumen sized for harvestingfollicular units, and an open, tissue-coring distal end in communicationwith the lumen. The harvesting tool further includes a grasping devicehaving a pair of opposing arms, each arm extending to a respective tip,wherein one or both of the harvesting cannula and grasping device beingmovable relative to the other. The grasping device has an open position,in which the arm tips are separated, and a closed position, in which thearm tips are positioned in close proximity to each other and beyond thedistal end of the harvesting cannula to facilitate grasping and/orsevering of a connective tissue strand connecting a follicular unit to abody surface from which the follicular unit was harvested. An actuationsystem is operatively coupled to the grasping device and is configuredto provide controlled, synchronized movement of the grasping device armsfrom the open position to the closed position, and from the closedposition to the open position, respectively. Alternatively, theactuation system may be configured to provide controlled lateral andlongitudinal movement of the grasping device arms, wherein lateralmovement of the grasping device arms is controlled independently fromlongitudinal movement of the grasping device arms.

More particularly, in various embodiments, the grasping device arm tipscomprise respective opposing tissue engaging surfaces. In oneembodiment, the respective tissue engaging surfaces are serratedsurfaces that mate when the grasping device is in the closed position.In another embodiment, the respective tissue engaging surfaces define acenter-hole when the grasping device is in the closed position, thecenter-hole being sized to accommodate a portion, for example, a bulb ofa follicular unit extending from the lumen of the harvesting cannula.

In some embodiments, one or both grasping device arm tips comprise atissue cutting surface. By way of non-limiting example, the respectivegrasping device arm tips may be beveled and configured to overlap andcut the connective tissue strand as the grasping device is moved fromthe open position to the closed position. By way of another,non-limiting example, the grasping device arm tips may have respectivetissue cutting surfaces configured to overlap and cut the connectivetissue strand in a scissor-like action as the grasping device is movedfrom the open position to the closed position. By way of a stillfurther, non-limiting example, one of the grasping device arm tipscomprises a tissue cutting surface, and the other comprises a dullsurface configured to meet the tissue cutting surface when the graspingdevice is in the closed position to facilitate cutting of the tissuestrand.

In some embodiments, at least one of the grasping device arm tips formsor is otherwise coupled to an energy transmitting element configured tosever the connective tissue strand. By way of non-limiting examples, theenergy transmitting element may be an electrode, an ultrasoundtransducer, or a laser, for conveying radio frequency, mechanical wave,or optical energy, respectively, through the connective tissue strand tosever same. In one such embodiment, one of the grasping device arm tipscomprises a first electrode, and the other comprises a second electrode,the first and second electrodes configured for completing a radiofrequency energy circuit through the connective tissue strand to therebysever same.

In various embodiments, a fluid conduit is coupled to one of thegrasping device arms, the fluid conduit having an outlet positioned fordelivering fluid (e.g., saline) proximate the open distal end of theharvesting cannula. In some embodiments, respective fluid deliveryconduits are coupled to both arms, each having an outlet configured todeliver fluid (e.g., saline) proximate the open distal end of theharvesting cannula. The presence of the fluid may have severalbeneficial effects, including but not limited to flushing away excesstissue and blood around the area of the harvested follicular unit on thebody surface, providing moisture to the follicular unit, lubricating apathway of the follicular unit from the harvesting cannula opening to astorage location, and helping to seal the distal end opening of theharvesting cannula surrounding the harvested follicular unit to therebyincrease the pulling force exerted on the follicular unit of a vacuumsource in communication with the interior harvesting cannula lumen.

In some embodiments, the respective tissue engaging surfaces of thegrasping device arm tips having corresponding grooves formed therein,which define a cavity for receiving a distal end portion of theharvesting cannula when the grasping device is in the closed position.In one such embodiment, outer sides of the respective grasping devicearm tips are tapered to their respective distal ends so as to form anarrow-shape when the grasping device is in the closed position, andwherein the grasping device arms are moveable relative to the harvestingcannula so that the respective distal ends of the grasper arm tips maybe inserted into the body surface to a depth beyond an insertion depthof the distal end of the harvesting cannula while harvesting of afollicular unit, and so that the respective tissue engaging surfaces ofthe grasping device arm tips can be moved together into the closedposition to retain the harvested follicular unit within the harvestingcannula as the respective harvesting cannula and grasping device aremoved out of the body surface. A respective fluid conduit may be coupledto one or both of the grasping device arms and having respective outletslocated in an inner wall of the respective tissue engaging surfacegrooves for delivering fluid into the cavity when the grasping device isin the closed position. The cavity may be dimensioned to at leastpartially seal the enclosed open distal end portion of the harvestingcannula within the cavity when the grasping device is in the closedposition to thereby enhance a pulling force of a vacuum source incommunication with the harvesting cannula lumen. Optionally, a furthertissue grasping device may be provided, wherein at least one of thesecond tissue grasping device arm tips has an energy transmittingelement (e.g., an RF electrode, ultrasound transducer, or laser)configured to sever the connective tissue strand while the first tissuegrasping device is in the closed position. By way of non-limitingexample, in one such embodiment, one of the second grasping device armtips comprises a first electrode, and the other comprises a secondelectrode, the first and second electrodes configured for completing aradio frequency energy circuit through the connective tissue strand tothereby sever same.

In some embodiments, the follicular unit harvesting tool furthercomprises a guide member having an axial passageway through which theharvesting cannula extends. The guide member has a distal interior borein communication with the axial passageway, and a distal facing endconfigured to mate with the grasping device arm tips when the graspingdevice is in the dosed position so as to at least partially seal theinterior bore and thereby enhance a pulling force of a vacuum source incommunication with the harvesting cannula lumen when the distal end ofthe harvesting cannula is positioned in the interior bore of the guidemember. In one such embodiment, the guide member axial passageway has aninner diameter sufficiently close to an outer diameter of the harvestingcannula so that tissue extending outwardly from the cannula distal endis displaced inwardly as the cannula distal end is withdrawn from theinterior bore into the axial passageway of the guide member. In a sameor different embodiment, the distal facing end of the guide memberconfigured to dislodge from the grasper arm tips any tissue extendingfrom a follicular unit carried in the harvesting cannula as the grasperdevice is moved from the closed position to the open position whileinitially mated to the guide member.

According to another aspect of the invention, in one embodiment, amethod for harvesting follicular units from a body surface includesinserting a distal end of a harvesting tool into the body surface tosurround and core a follicular unit; withdrawing the distal end of theharvesting tool from the body surface with the follicular unit at leastpartially retained in an interior lumen of the harvesting tool; andmoving one or both of a grasping device operatively associated with theharvesting tool and the harvesting tool relative to each other so thattwo arm tips of a pair of opposing arms of the grasping device extendbeyond the distal end of the harvesting tool and in close proximity toeach other to facilitate grasping and/or severing of a connective tissuestrand connecting the follicular unit to the body surface.

The method of this embodiment may further comprise severing theconnective tissue strand connecting the follicular unit to the bodysurface. In one such embodiment, the method includes applying energy tothe connective tissue strand through an energy transmitting elementoperatively connected to at least one arm of the grasping device tosever the connective tissue strand from the follicular unit. By way ofnon-limiting example, one of the grasping device arms may have a tissueengaging tip comprising a first electrode, and the other tissue engagingtip comprising a second electrode, wherein the connective tissue strandis severed by completing a radio frequency energy circuit through thestrand via the respective electrodes.

In one embodiment, the grasping device comprises a first tissue graspingdevice, and the method includes engaging the follicular unit and theconnective tissue strand with the first tissue grasping device, anddelivering energy to sever the connective tissue strand via an energytransmitting element operatively connected to at least one arm of asecond tissues grasping device.

In yet another embodiment, the arms of the grasping device havecorresponding grooves to define a cavity, and the method includes movingthe harvesting tool and/or the grasping device relative to each othersuch that the distal end of the harvesting tool is received within thecavity. Preferably, the cavity is dimensioned to at least partially sealthe enclosed open distal end portion of the harvesting tool, forexample, a cannula, within the cavity to thereby enhance a pulling forceof a vacuum source in communication with the harvesting cannula lumen.In one such embodiment, the method includes moving the grasping devicerelative to the harvesting cannula to thereby insert the respective armtips of the grasping device into the body surface to a depth beyond aninsertion depth of the distal end of the harvesting tool, and closingtissue engaging surfaces of the grasping device arm tips to retain theharvested follicular unit within the harvesting tool as the harvestingtool is retracted from the body surface.

According to yet another aspect of the present invention, in oneembodiment, a method for harvesting follicular units from a body surfaceincludes positioning an open, tissue-coring distal end of a harvestingcannula proximate a follicular unit to be harvested; inserting theharvesting cannula distal end into the body surface, surrounding andthereby coring the follicular unit; withdrawing the harvesting cannuladistal end from the body surface with the follicular unit at leastpartially retained in an interior lumen of the harvesting cannula;closing opposing tissue engaging surfaces of a grasping deviceoperatively associated with the harvesting cannula to thereby engage oneor both of (i) a portion of the follicular unit extending out of theopen distal end of the cannula, and (ii) a connective tissue strandconnecting the follicular unit to the body surface; and severing theconnective tissue strand by retracting the grasping device from the bodysurface.

Various embodiments of the disclosed follicular harvesting methods mayfurther include delivering fluid (such as saline) through a fluidconduit coupled to the grasping device, the fluid conduit having anoutlet positioned for delivering fluid proximate the distal end of theharvesting tool. The fluid may provide several benefits, including(without limitation) flushing away excess tissue and blood around thearea of the harvested follicular unit on the body surface, providingmoisture to the follicular unit, lubricating a pathway of the follicularunit within the harvesting cannula, and helping to seal the distal endof the harvesting cannula surrounding a harvested follicular unit toincrease the pulling force of a vacuum source in communication with theinterior harvesting cannula lumen.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing and other aspects of various embodiments of the presentinvention will best be appreciated with reference to the detaileddescription of embodiments in conjunction with the accompanyingdrawings, wherein:

FIG. 1 is a perspective view of a robotic arm system used forpositioning and orienting a follicular unit harvesting cannula extendingfrom a tool assembly housing carried by a robotic arm and used forharvesting human hair follicular units.

FIGS. 2A-2C are perspective views of an exemplary embodiment of afollicular unit harvesting tool incorporating one embodiment of agrasping device.

FIG. 3 is a perspective, exploded view of a first pneumatic actuationsystem used for actuating the respective grasping device and harvestingcannula of the harvesting tool shown in FIGS. 2A-2C.

FIG. 4 is a perspective close up view of the distal portion of theharvesting tool shown in FIGS. 2A-2C, including a first embodiment ofthe grasping device.

FIGS. 5A-5G are respective perspective views of alternative exemplaryembodiments of the grasping device for use with the harvesting toolshown in FIGS. 2A-2C.

FIG. 6 is a perspective view of a follicular unit guide that may be usedwith (or incorporated as part of) a follicular unit harvesting tool.

FIGS. 7A-7D are perspective views of an exemplary embodiment of afollicular unit harvesting tool incorporating a grasping device alongwith the follicular unit guide shown in FIG. 6.

FIGS. 8A-8C are perspective views of still another exemplary embodimentof a follicular unit harvesting tool, including a grasping device.

FIG. 9 is a perspective view of a modified embodiment of the follicularunit harvesting tool shown in FIGS. 8A-8C, including an additionalgrasper device that employs an energy transmitting element to sever anyconnective tissue strands while the first grasper retains the harvestedfollicular unit.

FIG. 10 is a perspective view of an inner side of an arm of an alternatetissue grasping device for use in the follicular unit harvesting tool ofthe present invention.

DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS

In the following Detailed Description, reference is made to theaccompanying drawings that show by way of illustration some exemplaryembodiments in which the invention may be practiced. In this regard,directional terminology, such as “top,” “bottom,” “distal,” “proximal,”etc., is used with reference to the orientation of the Figure(s) beingdescribed. Because components or embodiments of the present inventioncan be positioned in a number of different orientations, the directionalterminology is used for purposes of illustration and is in no waylimiting. It is to be understood that other embodiments may be utilized,and that many structural or logical changes may be made to theillustrated embodiments, without departing from the scope of the presentinvention. It is to be further understood that the various features ofthe illustrated embodiments may be used with or incorporated intofurther embodiments, even if not so illustrated or specificallydescribed.

The term “harvesting tool” as used herein refers to any number of toolsor end effectors that are capable of removing or harvesting follicularunits from a body surface. In this sense, a body surface can be attachedto the body or may be a flap of skin or body tissue removed from thebody. Such tools may have many different forms and configurations. Inmany embodiments, the tool comprises a hollow tubular shaft and thus maybe labeled, for example, a cannula, a needle, or a punch. The terms“coupled,” or “attached,” or “mounted” as used herein, may mean directlyor indirectly coupled, attached, or mounted through one or moreintervening components. The distal end of the harvesting cannula mayhave many different forms and configurations (e.g., beveled, sharp,dull, textured, have slotted openings or side windows, etc), as may bedesired for accessing the body surface, coring and retaining theharvested follicular unit. By way of non-limiting example, theharvesting cannula may include a pair of coaxially positioned cannulas,including a first one with a tissue piercing distal tip used to make theinitial incision into the body surface, and a second one having a dulltip used to core the follicular unit after the initial incision is made.Examples of such a harvesting tool are disclosed in U.S. PatentPublication 2005/0267506 to Harris.

In order to better understand the context and uses of the illustratedand described embodiments of the invention, an exemplary (automated)hair transplantation system is first described for purposes ofillustration and not limitation. It is to be understood that variousembodiments of the invention may be used with this exemplary automatedsystem, as well as with many other types of follicular unit harvestingsystems and apparatus, including automated, semi-automated, and manuallyoperated systems and instruments.

FIG. 1 depicts an exemplary image-guided robotics system 25, asdescribed in detail in the above-referenced U.S. Patent Publications2007/0078466 and 2007/0078475. The robotics system 25 includes a roboticarm 27 having a follicular unit harvesting tool assembly 30 attached toa distal tool plate 20 of the robotic arm 27. The harvesting toolassembly 30 includes a harvesting needle (or “cannula”) 36 extendingfrom a tubular body 24, which in turn extends from a tool housing 22attached to the tool plate 20. The harvesting cannula 36 is axiallystiff, e.g., made of a hard metal or plastic, and thin-walled tofacilitate tissue penetration. The cannula 36 has an open, tissue-coring(e.g., rough or serrated) distal tip 37 in communication with aninterior lumen appropriately sized for harvesting singular human hairfollicular units by coring the respective follicular units andextracting them from a body surface (typically but not necessarily ascalp). By way of non-limiting examples, embodiments of the harvestingcannula 36 may have interior lumens that range from approximately 0.3millimeters to 2.0 millimeters in diameter. In one embodiment, theharvesting cannula lumen has a diameter that is approximately 1millimeter in diameter. Notably, different sized harvesting cannulas 36may be used for harvesting single-follicle follicular units than forharvesting multi-follicle follicular units. In either case, an innerwall surface of the harvesting cannula lumen may be textured tofacilitate frictional grasping the respective follicular units forextraction from the body surface after they are cored.

The robotic arm 27 has a base 29 mounted on a stable platform (table)23. A patient 38 is positioned relative to the robotic arm 27, so that atargeted body surface (in this instance, the donor area on the back of apatient's scalp) 32 is directly underlying the distal tip 37 of theharvesting cannula 36. As is described in the above-referenced U.S.Patent Publications 2007/0078466 and 2007/0078475, the robotic system 25includes one or more cameras 28 (two are visible in FIG. 1) mounted onthe tool housing 22. A processor (not shown) associated with the roboticsystem 25 receives and processes images acquired by the one or morecameras 28. The processor and/or a controller (also not shown) that isoperatively associated with the processor are configured to preciselymaneuver the arm 27 in six degrees of freedom based, at least in part,on images acquired by the one or more cameras 28 and processed by theprocessor. In this manner, the robotic arm 27 automatically andprecisely positions the harvesting cannula 36 at desired locations, andin desired orientations relative to follicular units targeted forharvesting from the body surface (e.g., the donor region on the scalp 32of the patient 38 shown in FIG. 1) based on control signals derived atleast in part from image data acquired by the one or more cameras 28.Movement of the harvesting cannula 36 relative to the patient 38 may beprovided by a number of different mechanical, electromechanical,pneumatic, hydraulic, magnetic, and other known systems and mechanismslocated in the tool housing 22 and coupled for effecting controlledmovement of the harvesting cannula 36 in addition to (and synchronizedwith) the controlled movement of the robotic arm 27.

In particular, for harvesting a follicular unit from a body surface(e.g., scalp 32), the robotic arm 27 positions and aligns the harvestingcannula 36 with a longitudinal axis of a selected follicular unit to beharvested. The harvesting cannula 36 is then advanced over the selectedfollicular unit by motion of the robotic arm 27 and/or a separate driveassembly located in the tool housing 22 that provides independentlycontrolled axial translation of the harvesting cannula 36, preferablyaccompanied by simultaneous rotational movement of the harvestingcannula about its longitudinal axis (e.g., by a servo motor located inthe housing 22), with the open distal end 37 of the cannula 36penetrating the body surface into the subcutaneous fatty layersurrounding and underlying the targeted follicular unit. The harvestingcannula 36 is then withdrawn from the body surface by motion of therobotic arm 27 and/or drive assembly within the tool housing 22 tothereby extract the follicular unit from the body surface.

It should be appreciated that, in alternate embodiments, the harvestingtool assembly may be hand-held and positioned, in which case movement ofthe harvesting cannula relative to the body surface may be manual,semi-automated, or completely automated. The harvesting cannula may befixed or independently moveable relative to the remainder of the toolassembly, whether the tool assembly is hand-held or attached to amoveable arm (e.g., robotic arm 27 in FIG. 1). In embodiments in whichthe tool assembly is carried on a robotic arm, movement of theharvesting cannula relative to the body surface may be performed bymovement of the arm relative to the body surface, movement of theharvesting cannula relative to the robotic arm, or a combination ofeach. Similarly, in hand-held embodiments, movement of the harvestingcannula relative to the body surface may be performed by movement of theoperator's arm relative to the body surface, movement of the harvestingcannula relative to the tool assembly, or a combination of each.

In some embodiments, whether automated, semi-automated, or entirelymanual, the harvesting cannula may be rotated about its longitudinalaxis as it penetrates the body surface to enhance its tissue-coringeffectiveness. In some or all embodiments, the wall of the harvestingcannula lumen may be textured in order to facilitate grasping andextracting the follicular unit. In some or all embodiments, a vacuumsource may be selectively placed in communication with the harvestingcannula lumen to apply a proximally directed “pulling” force tofacilitate grasping and extracting the follicular units. These featuresmay also be helpful in retaining the follicular unit in the harvestingcannula lumen after it is harvested.

It should be appreciated that the particular configuration andarrangement of the harvesting cannula is not critical to implementingthe invention. For example, instead of a single harvesting cannula, theharvesting tool (whether automated, semi-automated, or manual) mayemploy axially-aligned, dual harvesting cannulas used for a sequential,two-step harvesting motion, such as described in the above-referencedU.S. Patent Publication 2005/0267506. Also, the tool assembly mayinclude a separate implanting cannula that may be co-axially arrangedwith the harvesting cannula, as is taught in the above-referenced U.S.Patent Publications 2007/0078466 and 2007/0078475. Still furtherharvesting cannula embodiments are possible, such as (withoutlimitation) a “two-part” harvesting and implanting cannula as shown anddescribed in commonly assigned U.S. patent application Ser. No.12/049,170, filed Mar. 14, 2008 [Publication Number to be added afterpublication].

In some cases, as a follicular unit is retracted from a body surface(e.g., a donor region on the back of a scalp) within the harvestingcannula, some tissue strands may tether the follicular unit to the bodysurface. As a result, as the harvesting cannula is retracted out andaway from the body surface, these tissue strands may pull the follicularunit out of the harvesting cannula, or the pulling force of the tissuestrands may damage the follicular unit. Even where a vacuum and/ortextured interior surface of the harvesting cannula is utilized, theforces may not be sufficient to break these tissue strands as theharvesting cannula is retracted and/or as the follicular unit is movedproximally into the harvesting cannula lumen. In accordance with thepresent invention, in order to cleanly separate the harvested follicularunit from such tissue strands, and maintain the follicular unit withinthe harvesting cannula without causing any significant damage thereto, agrasping device may be incorporated with the harvesting cannula utilizedto help sever any remaining strands of tissue connecting the follicularunit to the body surface as it is harvested. In various embodiments, thegrasping device is a mechanism that grasps and severs the strands oftissue by one or both of a pinching of the strand(s) by the grasperproximate the follicular unit base and the pulling force of theretracting harvesting cannula while the harvested follicular unit issecured in place by the (closed) grasper. Additionally and/oralternatively, the grasping device may employ a passive or activecutting mechanism (e.g., a mechanical blade, a laser, an ultrasonicenergy device, or an electrode for conducting RF energy) to cut thestrands of tissue from the harvested follicular unit.

An exemplary embodiment of a follicular unit harvesting system 50including one such grasping device 52 is depicted in FIGS. 2A-2C. Thesystem 50 may comprise components utilized in the harvesting toolassemblies described in the above-referenced U.S. Patent Publications2007/0078466 and 2007/0078475, including various modifications whichwill be readily apparent to those skilled in the art. In addition to thegrasping device 52, the system 50 may generally comprise a harvestingtool assembly 54, an LED illumination assembly 56, and a storagecartridge 58 for storing harvested follicular units for laterimplantation.

The respective grasping device 52 and the harvesting tool assembly 54are pneumatically actuated in this exemplary embodiment, but it shouldbe understood that other actuation devices may be utilized, such aselectric motors, solenoids, etc. Accordingly, the harvesting toolassembly 54 is operatively coupled to a first air cylinder 60, which isin fluid communication with a first pneumatic actuation valve 61; andthe grasping device 52 is operatively coupled to a second air cylinder62, which is in fluid communication with a second pneumatic actuationvalve 63. A source of compressed air 64 is in fluid communication withthe respective first and second pneumatic actuation valves 61 and 63, aswell as an air exhaust vent 66. The harvesting tool assembly 54comprises a harvesting cannula 68 extending from a hub 70 coupled to thefirst air cylinder 60. The grasping device 52 has a pair of arms 72 and74, which extend proximally from respective distal tips 73 and 75 toactuating cams 78 and 80 (see FIG. 3) operatively coupled to the secondair cylinder 62.

Turning to FIG. 3A, the actuating cams 78 and 80 each comprise a base(82 and 84, respectively) having a cam slot (86 and 88, respectively)and slider pin hole (87 and 89, respectively). The respective slider pinholes 87 and 89 receive a slider pin 90 which is coupled to a slider 92.A stationary “cam pin” 94 is received by the respective cam slots 86 and88 of the actuating cams 78 and 80. The slider 92 is operatively coupledto an air cylinder rod 96, which is in turn received in the second aircylinder 62.

Operation of this exemplary cam system is as follows: The air cylinderrod 96 is actuated by operation of the second pneumatic actuation valve63, which pressurizes the second air cylinder 62, and causes the slider92 to move distally if the grasping device arms 72 and 74 are beingclosed, or proximally if the arms 72 and 74 are being opened. The motionof the slider 92 and (by extension) the slider pin 90 causes theactuating cams 78 and 80 to move along with the slider 92, therebymoving the respective tips 73 and 75 of the grasping device arms 72 and74 in a respective distal or proximal direction, depending on theparticular step of the harvesting operation. And, as the actuating cams78 and 80 move distally or proximally, the cam slots 86 and 88 moverelative to the cam pin 94. When respective angled portions 97 and 99 ofthe respective cam slots 86 and 88 travel along the cam pin 94, the cams78 and 80 rotate about the slider pin 90, thereby causing the respectivearms 72, 74 and tips 73 and 75 to move towards each other in a clampingmotion when the cams 78 and 80 move distally, or away from each other ina releasing motion when the cams 78 and 80 move proximally. Preferably,the cams 78 and 80 are positioned so that the respective grasper arms 72and 74 move symmetrically about the centerline of the harvesting cannula68. In this manner, the cam system shown in FIG. 3 provides controlled,synchronized movement of the grasping device arms 72 and 74 from theopen position to the closed position, and from the closed position tothe open position, respectively.

An alternative cam system may be employed, which is configured toprovide controlled lateral and longitudinal movement of the graspingdevice arms 72 and 74, wherein lateral movement of the arms iscontrolled independently from longitudinal movement, thus allowing thegrasping device arms close after they have been extended longitudinally.In particular, the air cylinder rod 96, may extend the grasping devicearms 72 and 74 forward to the tip of the harvesting needle, 68. Once thegrasping device arms 72 and 74 are fully extended to the tip of theharvesting needle, 68, a secondary air cylinder may be employed topush-pull the grasping arms 72 and 74 toward each other, much like themanner in which a hand-caliper on a bicycle push-pulls the brakecalipers together. A compression spring between the grasping device arms72 and 74 may separate the device arms when the secondary air cylinderis released, thereby allowing the grasping device arms to retractlongitudinally. Many and various other appropriate mechanisms forproviding controlled movement of the grasping device arms in one or bothof the lateral and longitudinal directions are also contemplated andwithin the scope of the present invention.

As best seen in FIGS. 5A and 5B, a fluid delivery tube 100 may also beprovided with the harvesting apparatus, the tube 100 extends along oneof the arms (arm 74B in the illustrated embodiment of FIG. 5B) of thegrasping device 52B (described in greater detail below). The fluiddelivery tube 100 has an outlet 102 located near the distal end opening69 of the harvesting cannula 68 when the grasping device 52B is in aclosed (or “clamping”) position (also shown in FIG. 2C). The fluiddelivery tube 100 is used to introduce a fluid, such as saline, into theharvesting cannula 68 and surrounding area, as the harvesting cannula isretracted from the body surface carrying a newly harvested follicularunit. The fluid provides several benefits, including flushing awayexcess tissue and blood around the area of the harvested follicular uniton the body surface, providing moisture to the follicular unit,lubricating a pathway of the follicular unit from the harvesting cannulaopening to the storage cartridge 58, and helping to seal the distal end69 of the harvesting cannula 68 surrounding the harvested follicularunit to thereby increase the pulling force exerted on the follicularunit of a vacuum source in communication with the interior harvestingcannula lumen.

FIG. 2A depicts the harvesting tool assembly 54 and grasping device 52in a “harvest ready” position, in which the grasping device 52 is in anopen position with the grasper arm tips 73 and 75 spread apart andextended beyond the distal end of the harvesting cannula 68. To harvesta follicular unit, the system 50 aligns the harvesting cannula 68 with aselected follicular unit to be harvested, for example, in a same manneror very similar to that described above for the system 25. Theharvesting cannula 68 is then may be advanced over the selectedfollicular unit by actuation of the first air cylinder 60, which sameforward motion advances the harvesting cannula 68 distally beyond therespective arm tips 73 and 75 of the grasping device 52 for puncturingthe skin and surrounds the follicular unit (not shown). This “harvestingposition” configuration of the respective harvesting tool assembly 54and grasping device 52 is shown in FIG. 2B. Thereafter, the harvestingcannula 68 is withdrawn from the body surface by retracting theharvesting tool assembly 54. The harvested follicular unit is retainedin the harvesting cannula 68 as it is withdrawn from the body surface bya friction fit that may be enhanced by using a vacuum source and/ortextured inner lumen wall.

As shown in FIG. 2C, as the harvesting cannula 68 exits the skin of thebody surface, a distal tip of the harvesting cannula 68 is nowpositioned proximal of the respective grasper arm tips 73 and 75, with aharvested follicular unit (not shown) retained inside the harvestingcannula 68. A vacuum may be utilized to help draw (and thereafterretain) the harvested follicular unit into the interior lumen of theharvesting cannula 68. By actuation of the second air cylinder 62, thedistal tips 73 and 75 of the arms 72 and 74 of the grasping device 52close around the end of the harvesting cannula 68 as it exits the bodysurface, thereby clamping down on and, in some embodiments, cutting anytissue strands (not shown) that may remain connecting the just-harvestedfollicular unit and the body surface. The harvesting cannula 68 and thegrasping device 52 continue to retract from the skin surface, therebysevering the connective tissue strands. Throughout this process, thefluid delivery tube 100 preferably introduces saline or another fluidinto and around the distal end opening of the harvesting cannula 68, forthe above-described purposes.

As best seen in FIG. 4, it will be appreciated that the “clamping tips”73 and 75 of arms 72 and 74 of the grasping device 52 may simply clampbetween them any tissue strands which remain connecting thejust-harvested follicular unit to the body surface (e.g., scalp) as theyare closed, whereby continued retraction of the respective harvestingcannula and grasping device away from the body surface is whateventually breaks the tissue strands while the follicular unit is safelyretained in the harvesting cannula lumen. It should also be appreciatedthat many variations and alterations of the grasping device 52 arepossible without departing from the inventive concepts disclosed herein.By way of non-limiting examples, several alternative embodiments of thegrasping device 52 having different distal arm tip configurations willnow be described. It should be appreciated that the respective graspingdevice arm tips of the various illustrated embodiments are biased(extend) towards one another, and have respective opposing tissueengaging surfaces. It should also be appreciated that the tips may bemade of many different bio-compatible materials, such as metal or hardplastic, e.g., stainless steel, polycarbonate, Teflon®, silicone,rubber.

Referring to FIG. 5A, one alternative grasping device 52A has arms 72Aand 74A configured with serrated grasper arm tips 73A and 75A to improvetheir grasping capability. FIG. 5B depicts another alternative graspingdevice 52B, having arms 72B and 74B with “over-center” tips 73B and 75B,respectively, which are beveled such that the beveled surfaces overlapwhen the grasping device 152 is in the closed position. As they closetogether, the beveled tips 73B and 75B may actively cut any connectivetissue strand(s), e.g. in a scissor-like fashion, thereby releasing thefollicular unit from the body surface without requiring additionalphysical pulling of the connective tissue, while minimizing potentialinjury to the follicular unit. FIG. 5C depicts a blunt tipped graspingdevice 52C wherein the tips 73C and 75C of the respective arms 72C and74C define a center-hole 105 when the grasping device 52C is in a closedposition. The center-hole 105 is sized to accommodate a wider portion ofthe follicular unit—and thereby prevent inadvertent cutting of a portionof a follicular unit that may be extending from the lumen of theharvesting cannula 68.

FIG. 5D depicts an embodiment of a cutting-grasping device 52D, in whichone grasper arm tip 73D has a sharp cutting edge (which may be formed,for example, of sharp surgical steel), and the other tip 75D has a flatsurface that functions as a blunt “chopping block” for the sharp cuttingedge. The blunt surface on tip 75D may be formed of a softer material,such as Teflon® or another polymer, which facilitates the cutting actionas the respective grasper arm tips 73D and 75D are closed together. FIG.5E depicts a still further grasping device 52E, in which both grasperarms 72E and 74E have tips 73E and 75E with cutting surfaces (e.g.,sharp edges) which meet and cut any connective tissue material betweenthem as the grasping device 52E is closed.

FIG. 5F depicts yet another grasping device 52F, in which the tip 75F ofone of the arms 74F includes an energy transmitting element 107configured to sever a connective tissue strand when the grasping device52F is in a closed configuration. By way of non-limiting examples, theenergy transmitting element 107 may comprise an electrode for conveyingradio frequency (RF) energy into the connective tissue strand (in whichcase a return electrode configured for attachment on the patient is alsoprovided for completing the circuit, as is well known in the art), oralternatively the may be an ultrasound transducer for conveying acousticwave energy into the connective tissue strand, or an optical lasersource for conveying laser energy into the connective tissue strand. Ineach instance, the connective tissue strand is severed by energy emittedfrom the energy transmitting element 107. FIG. 5G depicts a stillfurther grasping device embodiment 52G, in which one of the graspingdevice arm tips 75G comprises a first electrode 109, and the other tip73G comprises a second electrode 111, the first and second electrodes109 and 111 being configured for completing a radio frequency energycircuit through an intervening connective tissue strand engaged betweenthe respective tips 73G and 75G when the grasping device 52G is in aclosed position. It will be appreciated that the implementation andoperation of the respective energy transmitting elements and electrodes(107, 109, 111) in the devices 52F and 52G of FIGS. 5F and 5G may becarried out according to well-known techniques and apparatus, and neednot be elaborated upon herein. By way of one, non-limited example, theenergy dosing level may be in a range of approximately 3-10 wattsapplied (for example) for up to 1 second. Notably, the tissue-severingenergy should be applied at a location sufficiently below the bulb ofthe harvested follicular unit so that the follicular unit itself is notharmed or damaged during the connective tissue severing process.

Referring generally to FIGS. 6 and 7A-D, in some embodiments, afollicular unit harvesting tool 170 further comprises a guide member 120that works in conjunction with the grasping device 152 to help captureand retain harvested follicular units (not shown in the Figures). In oneembodiment (best seen in FIG. 6), the guide member 120 has an elongatecylindrical body 122 defining an axial passageway 128 through which theharvesting cannula 168 extends. The guide member body 122 may furtherdefine an interior bore 121 within its distal end, the bore 121 having aproximal tapered portion 123 leading to an opening 125 in communicationwith the axial passageway 128. A distal facing end 127 of the guidemember body 122 includes spaced apart extensions 124 and 126 that haveflat inward facing surfaces configured to mate with the grasping devicearm tips 173 and 175 (best seen in FIG. 7C), with respective arcuate endsurfaces 131 a and 131 b spanning between extensions 124 and 126 form a“stop” to limit distal motion of the guide member 120 relative to the(closed) grasping device arm tips 173 and 175.

Referring specifically to FIG. 7A, the guide member 120 is shownincorporated into the follicular unit harvesting device 170. Theharvesting tool further comprises a respective grasping device 152 andharvesting tool assembly 154, which are configured and may be controlledin the same manner as the respective grasping device 52 and harvestingtool assembly 54 of the above-described harvesting tool 50. Briefly, theharvesting tool assembly 154 comprises a harvesting cannula 168extending from a hub 170, wherein the harvesting cannula 168 is movablerelative to the grasping device 152 and guide member 120, and extendsthrough the axial passage 128 and distal interior bore 121 of the guidemember 120. The grasping device 152 has a pair of arms 172 and 174 whichextend proximally from respective distal tips 173 and 175 to anactuating system (not shown) that controls movement of the graspingdevice from an open position, in which the arm tips 173 and 175 areseparated (shown in FIG. 7A), and a closed position, in which the armtips 173 and 175 are positioned in close proximity to each other andbeyond the distal end of the harvesting cannula 168 (shown in FIGS. 7Band 7C). The harvesting tool 170 is shown in a “harvest ready”configuration in FIG. 7A, with the distal end of the harvesting cannula168 extending through the open distal end 127 of the guide member 120and beyond the open grasper arms 172 and 174 for harvesting a follicularunit from a body surface (not shown). A fluid (e.g., saline) deliveryport 158 is also depicted on a distal end of one of the grasper arms172. However, it should be appreciated that the illustrated location ofthe fluid delivery port 158 is merely one example, and that one or morefluid delivery ports may be provided at other locations on the graspingdevice 152, as is the case with other embodiments depicted herein.

Referring to FIG. 7B, following the harvesting of a follicular unit, theharvesting cannula 168 is retracted relative to the grasping device 152,which is moved to its closed position. For purposes of illustrationonly, a piece of tissue 161 is shown extending from between the closedgrasper arm tips 173 and 175, which tissue 161 may be a portion of theharvested follicular unit, a connective tissue strand attached to theharvested follicular unit, or both. It will be appreciated that theclosing force on the tips 173 and 175 is minimized to prevent damagingthe tissue 161 in the event it is (at least in part) a portion of theharvested follicular unit.

Referring to FIG. 7C, while the grasping device 152 remains in theclosed position, the guide member 120 is moved distally along theharvesting cannula 168 (as indicated by arrow 180), until the distalfacing end 127 of the guide member 120 mates with the closed graspingdevice arm tips 173 and 175, resulting in the distal end of theharvesting cannula 168 being positioned within the interior bore 121 ofthe guide member 120. In particular, the mated guide member 120 andgrasper arm tips 173 and 175 at least partially seal the interior bore121 of the guide member 120, thereby enhancing a pulling force of avacuum source in communication with the harvesting cannula lumen. Thegrasping device 152 then begins to return to the open position,releasing the follicular unit as the arm tips 173 and 175 separate, andthe harvested follicular unit is drawn into a more proximal interiorregion of the harvesting cannula assembly 154 due to the built-upenhanced vacuum pulling force. It should be appreciated that relativemovement of the guide 120 over the harvesting cannula 168 may beaccomplished by an automated mechanism or by manual manipulation. Forexample, a small air cylinder could actuate the guide member, 120, alongthe harvesting cannula, 168.

Referring to FIG. 7D, generally after the opening of the grasping devicearms 172 and 174, the guide member 120 is further advanced distally overthe harvesting cannula 168 (indicated by arrow 190), although it will beappreciated that the harvesting cannula 168 can be retracted relative tothe guide member 120 to accomplish the same relative motion. Inparticular, the axial passageway 128 of the guide member 120 has aninner diameter sufficiently close to an outer diameter of the harvestingcannula 168 such that any remaining tissue associated with the harvestedfollicular unit extending outwardly from the cannula distal end isdislodged inwardly at the opening 125 as the cannula distal end iswithdrawn from the interior bore 121 and into the axial passageway 128.Similarly, any tissue associated with the harvested follicular unit thatmay be stuck or adhered to the grasper arm tips 173 and 175 is dislodgedas the respective tips open and move laterally over the distal arcuateedges 131 a and 131 b of the guide member 120. It should be appreciatedthat the guide member 120 can have the further advantage of directing agreater quantity of fluid (e.g., saline) into the harvesting cannulalumen due to its “funnel-like” configuration.

FIGS. 8A-8C are perspective views of still another exemplary embodimentof a follicular unit harvesting tool 250, including a grasping device252 and a harvesting tool assembly 254. The grasping device 252 andharvesting tool assembly 254 are similarly configured to, and may becontrolled in the same manner as, the respective grasping device 52 andharvesting tool assembly 54 of the above-described harvesting tool 50.The harvesting tool assembly 254 comprises a harvesting cannula 268extending from a hub 270, wherein the harvesting cannula 268 is movablerelative to the grasping device 252. The grasping device 252 has twoarms 272 and 274 extending proximally from respective distal tips 273and 275 to an actuating system (not shown) that controls movement of thegrasping device 252 from an open position, in which the arm tips 273 and275 are separated (shown in FIG. 8A), and a closed position, in whichthe arm tips 273 and 275 are positioned in close proximity to each otherand beyond the distal end of the harvesting cannula 268 (shown in FIGS.8B and 8C).

In accordance with this embodiment, the respective grasping device armtips 273 and 275 comprise opposing tissue engaging surfaces 280 havingcorresponding grooves 282 formed in a proximal portion thereof. Whilethe respective tissue engaging surface 280 and groove 282 formed thereinare only visible in tip 275 because of the angle of the perspective viewin FIGS. 8A-8C, it should be appreciated that the unseen tissue engagingsurface 280 and groove 282 on tip 273 are essentially a mirror image ofthe same components on tip 275. The respective grooves 282 on thesurfaces 280 of tips 273 and 275 define a cavity for receiving a distalend portion of the harvesting cannula 268 when the grasping device 252is in the closed position, and the respective tissue engaging surfaces280 are brought together (shown in FIG. 8C). The respective grooves 282are preferably dimensioned so that the resulting cavity snuggly seatsthe distal end of the harvesting cannula 268 to at least partially sealits open distal end 269 and thereby enhance a pulling force of a vacuumsource in communication with the inner harvesting cannula lumen. Thetissue engaging surfaces 280 of the grasper arm tips 273 and 275 eachmay further comprise a distal serrated portion 281 to improve theirgrasping capability when the grasping device 252 is in the closedposition (shown in FIG. 8C).

The follicular unit harvesting tool 250 may further include a firstfluid conduit 200 a coupled to grasping device arm 272, and a secondfluid conduit 200 b coupled to grasping device arm 274. The first andsecond fluid conduits 200 a and 200 b have respective outlets (not shownin the Figures) located in an inner wall of the respective tissueengaging surface grooves 282 of the respective tissue engaging surfaces280 for delivering fluid into the cavity formed by grooves 282 when thegrasping device 252 is in the closed position. Directing fluid into thecavity while the grasping device 252 is in a closed position will helpseal the open distal end of the cannula 269 and improve the pullingforce of a vacuum source in communication with the interior harvestingcannula lumen. It will be appreciated that alternate embodiments mayemploy only a single, or multiple (or no) fluid conduit, have differentconfigurations and shapes of such one or more fluid conduits, as well asuse different methods and ways of attaching such fluid conduits,moreover the fluid outlet ports may be placed in other locations.

In accordance with a particular aspect of this embodiment, the outwardfacing sides of the respective grasping device arm tips 273 and 275 aretapered to their respective distal ends so as to form an arrow-shapewhen the grasping device 252 is in the closed position. As seen in FIG.8B, the grasping device arms 272 and 274 are moveable along the outersurface of the harvesting cannula 268 when in their open position sothat the respective distal ends of the grasper arm tips 273 and 275 maybe inserted into a body surface to a depth beyond an insertion depth ofthe distal end 269 of the harvesting cannula 268 when harvesting afollicular unit. In this manner, as seen in FIG. 8C, the respectivetissue engaging surfaces 280 of the grasping device arm tips 273 and 275can then be moved into the closed position to retain the harvestedfollicular unit within the interior lumen of the harvesting cannula 268,and within the cavity formed by the grooves 282 in the respective tissueengaging surfaces 280 of the grasper arm tips 272 and 274, as therespective harvesting cannula 268 and grasping device 252 are moved outof the body surface.

In an alternate embodiment shown in FIG. 10, to facilitate sliding ofthe grasping device arms along the harvesting cannula, the “groove” inthe tissue grasping surface (designated as 280 a in FIG. 10) may extendas a smooth channel 282 a from the distal grasping portion 281 a of thesurface 280 a proximally along the entire length (or, in somealternative embodiments, any portion thereof) of the grasper arm(designated as 274 a in FIG. 10).

FIG. 9 is a perspective view of a modified embodiment of the follicularunit harvesting tool 250 shown in FIGS. 8A-8C (and given referencenumber 350 in FIG. 9). In particular, the tool 350 includes anadditional grasper device 352 that has respective arms 372 and 374surrounding the grasper device 252. The arms 372 and 374 extend toinwardly directed distal tips 373 and 375, respectively, wherein one orboth of the tips 373 and 375 employs an energy transmitting element tosever any connective tissue strands 361 while the first grasper arm tips273 and 275 retain the harvested follicular unit. As with theabove-described embodiments of FIGS. 5F and 5G, the energy transmittingelement carried by one or both of the tips 373 and 375 may be, by way ofnon-limiting example, an electrode for transmitting RF energy, anultrasound transducer for transmitting mechanical wave energy, or alaser for transmitting optical energy. In one variation of theembodiment shown in FIG. 9, a first one of the second grasping devicearm tips 273 comprises a first electrode, and the other tip 275comprises a second electrode, the first and second electrodes configuredfor completing a radio frequency energy circuit through the connectivetissue strand 361 to thereby sever same.

It should be appreciated from the foregoing description taken inconjunction with the accompanying figures that various methods forharvesting follicular units from a body surface using a follicular unitharvesting tool incorporating a grasping device have also beendisclosed. To further summarize such disclosed methods, by way ofnon-limiting example, a method according to one embodiment of theinvention includes the acts of: (i) inserting a distal end of aharvesting tool into the body surface to surround and core a follicularunit (ii); withdrawing the distal end of the harvesting tool from thebody surface with the follicular unit at least partially retained in aninterior lumen of the harvesting tool; and (iii) moving one or both of agrasping device operatively associated with the harvesting tool and theharvesting tool relative to each other so that two arm tips of a pair ofopposing arms of the grasping device extend beyond the distal end of theharvesting tool and in close proximity to each other to facilitategrasping and/or severing of a connective tissue strand connecting thefollicular unit to the body surface.

In one such embodiment, the method includes applying energy to theconnective tissue strand through an energy transmitting elementoperatively connected to at least one arm of the grasping device tosever the connective tissue strand from the follicular unit. By way ofnon-limiting example, one of the grasping device arms may have a tissueengaging tip comprising a first electrode, and the other tissue engagingtip comprising a second electrode, wherein the connective tissue strandis severed by completing a radio frequency energy circuit through thestrand via the respective electrodes.

In another such embodiment the grasping device comprises a first tissuegrasping device, and the method includes engaging the follicular unitand the connective tissue strand with the first tissue grasping device,and delivering energy to sever the connective tissue strand via anenergy transmitting element operatively connected to at least one arm ofa second tissues grasping device.

In a further embodiment, the arms of the grasping device havecorresponding grooves to define a cavity, and the method includes movingthe harvesting tool and/or the grasping device relative to each othersuch that the distal end of the harvesting tool is received within thecavity. Preferably, the cavity is dimensioned to at least partially sealthe enclosed open distal end portion of the harvesting tool within thecavity to thereby enhance a pulling force of a vacuum source incommunication with the harvesting tool lumen.

In one additional embodiment, the method includes moving the graspingdevice relative to the harvesting tool, for example, a harvestingcannula to thereby insert the respective arm tips of the grasping deviceinto the body surface to a depth beyond an insertion depth of the distalend of the harvesting tool, and closing tissue engaging surfaces of thegrasping device arm tips to retain the harvested follicular unit withinthe harvesting tool as the harvesting tool is retracted from the bodysurface.

In another embodiment, a method for harvesting follicular units from abody surface includes (i) positioning an open, tissue-coring distal endof a harvesting cannula proximate a follicular unit to be harvested;(ii) inserting the harvesting cannula distal end into the body surface,surrounding and thereby coring the follicular unit; (iii) withdrawingthe harvesting cannula distal end from the body surface with thefollicular unit at least partially retained in an interior lumen of theharvesting cannula; (iv) closing opposing tissue engaging surfaces of agrasping device operatively associated with the harvesting cannula tothereby engage a portion of the follicular unit extending out of theopen distal end of the cannula and/or a connective tissue strandconnecting the follicular unit to the body surface; and severing theconnective tissue strand by retracting the grasping device from the bodysurface.

Various follicular harvesting methods according to the disclosedinvention may include delivering fluid (such as saline) through a fluidconduit coupled to the grasping device, the fluid conduit having anoutlet positioned for delivering fluid proximate the distal end of theharvesting tool. The fluid may provide several benefits, includingflushing away excess tissue and blood around the area of the harvestedfollicular unit on the body surface, providing moisture to thefollicular unit, lubricating a pathway of the follicular unit within theharvesting cannula, and helping to seal the distal end of the harvestingcannula surrounding a harvested follicular unit to increase the pullingforce of a vacuum source in communication with the interior harvestingcannula lumen.

The foregoing illustrated and described embodiments of the invention aresusceptible to various modifications and alternative forms, and itshould be understood that the invention generally, as well as thespecific embodiments described herein, are not limited to the particularforms or embodiments disclosed, but to the contrary cover allmodifications, equivalents and alternatives falling within the scope ofthe appended claims. By way of non-limiting example, it will beappreciated by those skilled in the art that particular feature orcharacteristic described in reference to one figure or embodiment may becombined as suitable with features or characteristics described inanother figure or embodiment. Similarly, the invention is not limited tothe use of a robotic system including a robotic arm, and that otherautomated and semi-automated systems may be utilized.

By way of non-limiting example, it will be appreciated by those skilledin the art that the invention is not limited to the use of a roboticsystem, and that other automated, semi-automated, and manual systems andapparatus may be used for positioning and actuating the respectiveharvesting cannulas and other devices and components disclosed herein.By way of another example, it will be appreciated by those skilled inthe art that while the foregoing harvesting tool embodiments aredescribed herein in the context of harvesting hair follicular units, thetools are not limited to the harvesting of hair follicular units, andmay be equally used for removing dermal and sub-dermal tissue plugs thatdo not contain hair follicular units.

What is claimed is:
 1. A method for harvesting follicular units from abody surface, comprising: inserting a distal end of a harvesting toolinto the body surface to surround and core a follicular unit;withdrawing the distal end of the harvesting tool from the body surfacewith the follicular unit at least partially retained in an interiorlumen of the harvesting tool; and moving at least two arms of a graspingdevice operatively connected to the harvesting tool to a closedposition, such that distal tips of the at least two arm of the graspingdevice are positioned in close proximity to each other and extend beyondthe distal end of the harvesting tool to grasp and/or sever a connectivetissue strand connecting the follicular unit to the body surface fromwhich the follicular unit is being harvested, wherein movement of the atleast two arms laterally to the closed position does not requiresimultaneous movement of the grasping device or a portion thereoflongitudinally.
 2. The method of claim 1, further comprising moving thegrasping device away from the body surface such that the tissue strandeventually breaks while the follicular unit is safely retained in theinterior lumen of the harvesting tool.
 3. The method of claim 1, furthercomprising severing the connective tissue strand connecting thefollicular unit to the body surface with a tissue cutting surface of oneor both of the grasping device arm tips.
 4. The method of claim 1,further comprising applying energy to the connective tissue strandthrough an energy transmitting element operatively connected to at leastone of the at least two arms of the grasping device to sever theconnective tissue strand from the follicular unit.
 5. The method ofclaim 4, wherein the energy is applied to the connective tissue strandby completing a radio frequency energy circuit through the connectivetissue strand.
 6. The method of claim 1, further comprising deliveringfluid through a fluid conduit coupled to the grasping device, the fluidconduit having an outlet positioned for delivering fluid proximate thedistal end of the harvesting tool.
 7. The method of claim 1, wherein thegrasping device comprises a first tissue grasping device, the methodfurther comprising engaging the follicular unit and the connectivetissue strand with the first tissue grasping device; and deliveringenergy to sever the connective tissue strand via an energy transmittingelement operatively connected to at least one aim of a second tissuegrasping device.
 8. The method of claim 1, further comprising receivinga distal end portion of the harvesting tool in a cavity defined bygrooves in the grasping device arm tips, such that the distal endportion of the harvesting tool is at least partially sealed.
 9. Themethod of claim 8, further comprising utilizing a vacuum source incommunication with the harvesting tool lumen to draw the follicular unitinto the lumen.
 10. The method of claim 1, wherein insertion orwithdrawal of the harvesting tool into or from the body surface isperformed by movement of a robotic arm to which the harvesting tool isattached, or movement of the harvesting tool relative to the roboticarm, or a combination of the above.
 11. The method of claim 1, whereininsertion or withdrawal of the harvesting tool into or from the bodysurface is performed by movement of an operator's arm relative to thebody surface.
 12. The method of claim 1, wherein moving the at least twoarms of the grasping device laterally comprises, moving the tips tooverlap.
 13. The method of claim 1, further comprising rotating theharvesting tool about its longitudinal axis while inserting it into thebody surface.
 14. A method for harvesting follicular units from a bodysurface, comprising: inserting a distal end of a harvesting tool intothe body surface to surround and core a follicular unit; retracting theharvesting tool from the body surface with the follicular unit at leastpartially retained in an interior lumen of the harvesting tool; andmoving two aims of a grasping device operatively connected with theharvesting tool to a closed position, such that blunt distal tips ofeach of the two arms are positioned in close proximity to each other andextend beyond the distal end of the harvesting tool but withoutpenetrating the body surface, to grasp one or both of (i) a portion ofthe follicular unit extending out of the distal end of the harvestingtool, and (ii) a connective tissue strand connecting the follicular unitto the body surface from which the follicular unit is being harvested.15. The method of claim 14, wherein the grasping device arm tipscomprise respective opposing tissue engaging surfaces, such that movingthe at least two arms of the grasping device to the closed positioncauses the device arm tips to mate.
 16. The method of claim 14, severingthe connective tissue strand by moving the grasping device away from thebody surface.
 17. The method of claim 14, further comprising applyingenergy to the connective tissue strand through an energy transmittingelement operatively connected to at least one arm of the grasping deviceto sever the connective tissue strand from the follicular unit.
 18. Themethod of claim 14, further comprising delivering fluid through a fluidconduit coupled to the grasping device, the fluid conduit having anoutlet positioned for delivering fluid into a cavity when the graspingdevice is in the closed position.
 19. The method of claim 14, whereinthe grasping device comprises a first tissue grasping device, the methodfurther comprising engaging the follicular unit and the connectivetissue strand with the first tissue grasping device; and deliveringenergy to sever the connective tissue strand via an energy transmittingelement operatively connected to at least one arm of a second tissuegrasping device.
 20. The method of claim 14, comprising providingsynchronized movement of the grasping device arms from the open to theclosed position, and from the closed to the open position respectively.21. The method of claim 14, further comprising moving two arms of agrasping device laterally without simultaneously moving the graspingdevice or a portion thereof longitudinally.